Changes of timing variables in swallowing of boluses with different viscosities in patients with dysphagia.

MedLine Citation:

PMID:
22864016
Owner:
NLM
Status:
Publisher

Abstract/OtherAbstract:

OBJECTIVE: To evaluate the timing of the swallowing process and the effect of bolus viscosity on swallowing. DESIGN: Prospective observational study. SETTING: General teaching hospital, rehabilitation unit PARTICIPANTS: We enrolled 82 dysphagic patients in a videofluoroscopic swallowing study (VFSS) from Jan 13, 2009 to Oct 22, 2009. Based on VFSS results, we classified patients as "thin fluid-aspirators" (n = 40) or as "non-aspirators" (n = 42). INTERVENTIONS: Swallowing of a 5 mL thick bolus and a 5 mL thin bolus in all patients. MAIN OUTCOME MEASURES: Kinematic analysis of various variables during the swallowing process (pharyngeal phase), including epiglottis contact with the bolus, laryngeal elevation, pharyngeal constriction, and upper esophageal sphincter opening. RESULTS: In both groups, the thin bolus arrived at the vallecular pouch earlier than the thick bolus. During swallowing of the thick bolus, the thin fluid-aspirators had a delayed latency of upper esophageal sphincter opening (LUEO), delayed laryngeal elevation to peak level (LPLE), and significantly longer rise time of laryngeal elevation (LPLE-LLE). CONCLUSIONS: Our results indicate clear differences in the degree of adaptation to bolus viscosity between patients classified as thin fluid-aspirators and as non-aspirators. These differences were mainly in activities of laryngeal elevators rather than pharyngeal constrictors.